Archive for April 2014

The Next Dose…

After my last post about “the gift of cancer” I must say that CLL has felt much less like a gift this month.  Joining the ranks of those with “a diagnosis” has given me a some insight into what our patients face all the time.  Recently, I received my second dose of humility.  I capped off a truly exhausting week in the hospital with a routine lab follow-up.  The last day of my 85-hour week I had my CBC checked, and my platelets dropped from the 100s to the 30s.  My first reaction was denial.  Lab error.  Unfortunately, they dropped further the next day and I realized that the little red bumps on my legs weren’t some skin reaction, but petechiae.  Bummer.  Turns out that in addition to the 2% of people diagnosed with CLL under age 40, I also joined the 20% who develop idiopathic thrombocytopenic purpura (ITP). The…

Hospitalists and the Federation of State Medical Boards (FSMB): A CEO Q&A

Humayun J. Chaudhry, D.O., M.S., MACP, FACOI, President and Chief Executive Officer, Federation of State Medical Boards    1. Firstly, Hank, thanks so much for spending a few minutes with our readers.  As you know, hospitalists devote most of their time in acute and subacute settings. Many of their clinical apprehensions relate to hospital and physician regulation and quality monitoring and how these rules intersect with inpatient care.  The Federation of State Medical Boards (FSMB) has a broad mission. What should hospitalists know about your organization given these concerns and do you have a role to play in assisting inpatient providers to improve patient care? To understand the mission of the Federation of State Medical Boards (FSMB), it’s helpful to understand the mission of state medical boards. States are authorized under the 10th Amendment to the U.S. Constitution to establish laws and regulations protecting the health, safety and general welfare of their citizens. To…

Broken RAC System Continues to Hurt Patients, Providers

by Dr. Bart Caponi MD, FHM “Inpatient” and “Observation” are terms familiar to every hospitalist, and to increasing numbers of patients and lawmakers.  The difference can be significant--while “inpatients” are covered by Medicare Part A, people in “observation” are not; nor do they gain access to other benefits, like nursing home rehabilitation.  Until recently, no one paid any attention to status, but now patients and doctors are oppressed by it.  Why? Recovery Audit Contractors (RACs). (more…)

Medical Scribes

The New York Times recently covered an article about the use of scribes in the medical industry (NYT). Although the use of scribes among hospitalists is unknown, there are reportedly 10,000 medical scribes working within hospitals and clinics. These scribes can cost between $20-$25 an hour, but anecdotally can save priceless time and energy for many types of physicians. Wondering how common this is among hospitalists; anyone out there using a scribe?

When Being There Is Not Enough

I'm no shrinking violet.  When I get an idea in my head, I'm like a dog with a bone, I don't let go.  And I have been crowing like a rooster forever about NPs and PAs and how life affirming and awesome we are; how we bring the party to the party; how anyone's practice could be smoothed out, enhanced, lifted, tightened, tucked made more glamorous and younger simply by our appearance.  All we had to do was show up and the practice would instantly be blinded by our supreme fabulousness!  I berated countless numbers of hapless physicians about hiring an NP/PA to the point of boring those poor sweet people to death!  Every time I heard of one our kind being hired I would feel a little thrill, do a little happy dance, hear all the little Who's down in Whoville scream out, "We are here! we are here!…
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